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Autoimmune and Inflammatory Disorders Research / Kawasaki Disease and Coronary Complications · Journal article
Cureus · August 24, 2026
Early or partial results. Treat as a signal, not a conclusion.
This case report describes IVIG-induced aseptic meningitis occurring seven days post-infusion in a 12-year-old with Kawasaki disease, presenting with headache, vomiting, fever, and neck stiffness. CSF showed neutrophilic pleocytosis (248 cells/mm³, 80% neutrophils) with negative cultures, and the patient recovered completely with supportive care. The report emphasizes that IVIG-associated aseptic meningitis may present later than the commonly cited 24–72 hour window and is benign if infectious causes are excluded.
Case report. A previously healthy 12-year-old boy with Kawasaki disease who received high-dose IVIG. Intervention: High-dose intravenous immunoglobulin (IVIG) for Kawasaki disease.
Aseptic meningitis developed seven days after high-dose IVIG for Kawasaki disease CSF pleocytosis measured 248 cells/mm³ with 80% neutrophils; Gram stain and bacterial cultures negative Complete recovery achieved with supportive care alone, without antimicrobial therapy
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Clinicians should recognize that IVIG-induced aseptic meningitis can occur beyond the commonly cited 24–72 hour window and maintain this in the differential diagnosis when meningitis develops in temporal association with IVIG therapy. Careful CSF interpretation and exclusion of infectious causes can prevent unnecessary antimicrobial therapy and prolonged hospitalization.
A single case report documenting an uncommon adverse event; provides clinical recognition value but no comparative data or incidence quantification to guide practice.
As stated by the source record.
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Clinicians should recognize that IVIG-induced aseptic meningitis can occur beyond the commonly cited 24–72 hour window and maintain this in the differential diagnosis when meningitis develops in temporal association with IVIG therapy. Careful CSF interpretation and exclusion of infectious causes can prevent unnecessary antimicrobial therapy and prolonged hospitalization.
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Intravenous immunoglobulin (IVIG)-induced aseptic meningitis is a rare but well-recognized neurological complication that may closely mimic bacterial meningitis, making diagnosis challenging. Prompt recognition is essential to avoid unnecessary antimicrobial therapy and prolonged hospitalization. We report the case of a previously healthy 12-year-old boy who developed aseptic meningitis seven days after receiving high-dose IVIG for Kawasaki disease (KD). He presented with severe headache, vomiting, fever, and mild neck stiffness. Cerebrospinal fluid (CSF) analysis demonstrated neutrophilic pleocytosis (248 cells/mm³, 80% neutrophils) with negative Gram stain and bacterial cultures. Following the exclusion of infectious causes, the patient recovered completely with supportive care alone. This case highlights that IVIG-induced aseptic meningitis may occur later than the commonly reported 24-72 hours after infusion. Awareness of this uncommon but benign adverse event, together with careful interpretation of CSF findings and exclusion of infectious meningitis, is essential to ensure appropriate management, avoid unnecessary investigations and antibiotic therapy, and reassure clinicians and families regarding its excellent prognosis.
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